From Minnesota, which has been at the centre of the world stage for many days now, comes a story which is not about riots and demonstrations. A World War II veteran named Chester Peake, was diagnosed with coronavirus in a Twin Cities long-term care facility. He was asymptomatic, but spent two-and-a-half weeks in isolation. He died on June 2, just short of his 100th birthday.
His death certificate listed the cause of his death as “social isolation, failure to thrive, related to Covid-19 restrictions” — loneliness, in other words.
Monday is World Elder Abuse Awareness Day. According to the United Nations, between 4 and 6% of elderly people have experienced some form of maltreatment at home. Older Americans lose an estimated US$2.6 billion or more annually due to elder financial abuse and exploitation.
Elder maltreatment can lead to serious physical injuries and long-term psychological consequences. The incidence of abuse is predicted to increase as many countries are experiencing rapidly ageing populations. Warehousing them in nursing homes is unlikely to help the situation, either. And feeling that they are a burden could easily push infirm elderly toward accepting euthanasia.
The Covid-19 crisis has made the topic of how we care for the elderly even more relevant. Canadian philosopher Monique Lanoix even described it as a “humanitarian crisis” which is taking place right under our eyes – not in Yemen or Haiti.
We think of humanitarian crises as taking place in countries that are poor or subject to war. However, it is happening and has been happening in Québec and across our country for decades now. I insist on calling it a humanitarian crisis even if it takes place in distinct centres and homes: it involves a large number of people who have been the subject of pervasive social neglect, workers and residents at the margins of society. This crisis calls for a reckoning of the way in which we treat people labelled dependent.
The global percentage of deaths in nursing homes and assisted living facilities is a matter of debate. The pandemic is still not over and countries, states and regions have idiosyncratic methods of tallying the deaths. But according to a study by the International Long Term Care Policy Network, it ranges from 19% in Hungary to 62% in Canada. A good guess would be that about 40% of all coronavirus deaths have been in elder care facilities.
What does that say about the way we treat the elderly? It has become obvious that it was not just a matter of the frailty of people in the homes. Panicking authorities simply did not bother to deploy resources to protect their most vulnerable citizens. Both in the US and the UK, nursing homes reported that staff did not have protective equipment, lacked testing, and were short on staff. As well, in New York and other places authorities forced nursing homes to accept patients who were recovering from a crisis. That was certifiable lunacy. As three doctors wrote in the BMJ:
Nursing homes are often viewed as being on the periphery of healthcare systems, and the place of last resort for care delivery. They are often privately owned, and therefore not seen as part of the responsibility of government or associated agencies.
Death is an inevitable part of old age. But this cannot be viewed as an acceptable reason for ignoring the growing numbers of covid cases and deaths in care homes. It suggests that these deaths don’t matter. They are not being counted because in some people’s minds, they don’t count. But that is not good enough.
Others agree. According to experts from the Frameworks Institute writing at the Stanford Social Innovation Review, “The hashtag #BoomerRemover emerged and started trending in mid-March as a way to mark and make light of ageist comments about the pandemic. And Tedros Adhanom Ghebreyesus, the head of the World Health Organization, had to repeatedly address public opinion that COVID-19 was not a serious concern because of initial public beliefs that it affected only older people.”
The Frameworks Institute experts point out that the pandemic has exposed the effects of ageism: “We can see the effects of ageism in under-resourced nursing homes and in insurance companies only partially covering the care they provide. Left unchecked, ageism will continue to have long-term, negative impacts—including elder abuse, depression, and early mortality—that discriminate against older adults and eventually affect us all.”
It is absolutely true that Black Lives Matter. In fact, African American and Latino nursing home residents appear to have suffered more than whites, for a range of reasons. But lest we forget in the current furore about racism, Old Lives Matter, too.
Is anyone listening?